The association between abnormal birth history and growth in children with CKD

Larry A. Greenbaum, Alvaro Muñoz, Michael F. Schneider, Frederick J. Kaskel, David J. Askenazi, Randall Jenkins, Hilary Hotchkiss, Marva Moxey-Mims, Susan L. Furth, Bradley A. Warady

Research output: Contribution to journalArticlepeer-review

69 Scopus citations

Abstract

Background and objectives: Poor linear growth is a well described complication of chronic kidney disease (CKD). This study evaluated whether abnormal birth history defined by low birth weight (LBW; <2500 g), prematurity (gestational age <36 weeks), small for gestational age (SGA; birth weight <10th percentile for gestational age), or intensive care unit (ICU) at birth were risk factors for poor growth outcomes in children with CKD. Design, setting, participants, & measurements: Growth outcomes were quantified by age-sex-specific height and weight z-scores during 1393 visits from 426 participants of the Chronic Kidney Disease in Children Study, an observational cohort of children with CKD. Median baseline GFR was 42.9 ml/min per 1.73 m2, 21% had a glomerular diagnosis, and 52% had CKD for ≥90% of their lifetime. Results: A high prevalence of LBW (17%), SGA (14%), prematurity (12%), and ICU after delivery (40%) was observed. Multivariate analyses demonstrated a negative effect of LBW (-0.43 ± 0.14; P < 0.01 for height and -0.37 ± 0.16; P = 0.02 for weight) and of SGA (-0.29 ± 0.16; P = 0.07 for height and -0.41 ± 0.19; P = 0.03 for weight) on current height and weight. In children with glomerular versus nonglomerular diagnoses, the effect of SGA (-1.08 versus -0.18; P = 0.029) on attained weight was more pronounced in children with a glomerular diagnosis. Conclusions: LBW and SGA are novel risk factors for short stature and lower weight percentiles in children with mild to moderate CKD independent of kidney function.

Original languageEnglish (US)
Pages (from-to)14-21
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Volume6
Issue number1
DOIs
StatePublished - Jan 1 2011

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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